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1989-007 . , � •:�t :"„nr.;.�..y.;':n'_ i, •-snl-.r . .Af'vTr+i)4:: -rgw..:vrriw::3'-,"+4.ra'-�,.•,� ,. e -:w,i�i",.,.Sx i_ zr'�e .f � r u MEN SON CERTIFICATE y01i CUPANI1Y TOWN OF QUEENSBURY WARREN COUNTY, NEW YORK July 24 ,��""��� } 1�. Gate t9 — Thin is to certify that work requested to be done as shown by Permit No, 21 `-) - i2 7 has been completed. This stnicture may be occupied as a lao ratio Chvner iE ��.Z CJ � tlL I�S11 �' ulk iC a E iil iIl By Order Town Board ArOW*-N OF QUEENSBURY l � Director of Hldg. & Code Enforcement -� -� BUILDING PERMIT Pi TOWN OF QUEENSBURY No 89 _ 07 ,i WARREN COUNTY, NEW YORK 0 PERMISSION is hereby granted to The Whole Donut Franchise Systems Inc . 0 OWNER of property located at Quaker Road Street, Road or Ave. �r I IJ in the Town of Queensbury, To Construct or place a Addition to Building �n Ln at the above location in accordance to application together with plot plans and other information hereto filed and approved and in compliance with the Town of Queensbury Building and Zoning Ordinance. t ? x 1. OWNER'S Address is kn 894 New Britain Avenue Hartford , Ct . 06106 w 2_ CONTRACTOR or BUILDER'S Name Self (D 3. CONTRACTOR or BUILDER'S Address � Cr N (b tj 4_ ARCHITECT'S Name p rt 5. ARCHITECT'S Address 6. TYPE of Construction — (Please indicate by X) XD { ) Wood Frame { ) Masonry { ) Steel { I 7. PLAINS and Specifications � No. 2280 sq . fto addition to building as per plot plan , specif - °!y cations , and application , and attached letter . a 8. Proposed Use Retail Stare $ 9 -4t) cPERMIT FEE PAID — THIS PERMIT EXPIRES September 1 19 89 (If a Ianger period is required an application for an extension musk be made to the Building and Zoning inspe'cctor of the Y' town of Queensbury before the expiration date j D Dated at the Town of Queensbury this Day of f ebruary 19 89 00 rt --- �--- O SIGNED BY - far the Town of Queensbury D Building and Zoning 1 nspeix r r r LQ M TO UN OF �7UEENS]3URY APPI. TCATTON FOR UUTL£1ING AND ZONING rIRT«IIT L'wt e- P ee,i.ev ed TOWN OF QUF.P'WSBLI V Rev.i.ewed &VLrLWCCr L, f Fee PCKISE aid $ WILDING AND CODES DiYARTPIENT Date I.bbued JA71- 219 UILDING & CODE DEPT, DAY and 11AVSL9ND ROADS RD I BOX 9c3 PeltrltaEt NO .nueENSlBt;Ry0NEt,+ YOjRK 2 2e o:1 'BIB Tole ( 518) 792-5832 Ext -204 it * IN IN ■ M '* W t ■ * ik '� ■ 1. 1. * w 1t 1t Y� i • ■ fl aF li • x yI w ■ ■ R • s ■ A PER?•4IT MUST BI OBTAINED BEFORE BEGINNING CONSTRUCTION . NO INSPIiCTIONS - VI LL BE MADE UNTIL APPLICANT HAS RGCEIVLD A VALID 1RUI LDINC PERMIT Ill. All applicable spaces an this application must be completed and the ti -� mature of the applicant must app, car on the reverse sick of this sheet . at at Y: is :t 7k 7k is * * l IA; k * k * do 7k is * 7C YG yL 7k :k NR 7k 7k iti ye 9r yf rl, e owner of this Property is : The Whole oonut Franchise F stemsInc . I Address 894 New Britain Ave . Hartforde CT 06106 TEL . 203 -527 - 3569 i . O , troperty location South Side Quaker Rd . East of Bay Rd . TAX MAP & tlas there been any split at this property since October 1 , x 55 . 3 yes no if yes , Planning Hoard Review is necessary . LOT NO . SUBDIVISION NAME , IF A.PPLT. CAnLE "1' he person responsible for supervision of work as regards Building Codes is : P . O . ADDRESS fiEL . NO . NA MF_ Tel taame of builder Address Tol r4"me of, Plumber Address Tel Name of Mason Address 14ATURE OF f'ROPOSCD WORK : „ ZONING INFORMATION ( Office use On ' !) ) CO0:;truCciorc of a iiew building ZONING DESIGNATION OF PROPERTY X Adalicion to a buil.ling r PERMITTED PRINCIPAL PERMITTED ACCESSORY � s �A1Cu.C"Lion to to 1:"uilding „ REVIEW REQUIRED -- PLANNING BOARD ZONING S30AR1] ( ico cic cncj� to .:xc .: ricer ti i mans; ions) OCI:► r wark {�]e criL�.: 1 SITE PLAN REVIEW APPROVED DATE { U14OSS AREA OV PROPOSLD, STIauC "i` C.1rtE r VARIANCE # APPROVED DATE 2280 sq ft . Remarks : 1st Floor _ ? n d Floor N /A s q f t . w CO!*tPf_L•"1'i iNl`OI Mh"I'1QN ict:rI D 1lL L.UIJ . 168 . 29T^'/153 . WgFA150N 15r1r .G N/A sq ft . aixu of prola.; rty -40 f4 Other Floors taciatiitcJ bUL1 .l1j%L1 ( s±1 Si ::•: { not cellar or basement ) as _. 00 Sit In & Take "TOTAL FLOOR AREA^ 2280 sq ft " Lxiacing builcYinyfs } U3J: Out of new utructur.: ft X ft ,� di:;cance fro�u L+roiac rry line F'aaal �dation-pier/slala/crawl/l�arrtial/ full Nrni�o=.c=+x hulloing , 57 ft (circle one: ) N/A * front yard 64 . 9 ft Rear yyard Na . of stories (habic:.able '�l�ace ) * side yards � a g rt :snd 57 . 5 fc 11g. t (y � } 14 . 3 ft . If on cornara :rado to ridcj. :c: tliacic from side: str'elic. C 1f re:aidential , no . of families N /A . OCCUPANLY INFOP44ATIC1N Hoo of rroomst xcluding bath:;), N /A_ .r t1o . of bedrooms N`/1k PRIMARY AUILDINC No . of b;atl:rooula.— N /A * On+3 family dwelling 11ritwAry y�:acintJ ::y::4�lu Hot Air 'two f:au►.i.ly dwulliny 'ryl3:: of Euel a MultiY.+la dwelling / Number of units - . No. of fi.rQplaC"4 LO bQ installed_� [,� + ,Permanent occupancy will :a wooa.t ::cova Ivy init:allaad'' N /A "L•r:an::ia:nc taeCulx.ncy (:untr:ai Air conal.Ltiuniog" N /A � Ilusinc:ss UU I �DI NC- �TYtrP, PR I IIIII S1"RuCTURF ] nclu::cxial Ocher ltanckti Cas1C.:u.l•cr Y Ll"7 cabin xf uddici ura , wlauc will 1;.a i. c:4d ranch K an:s!"t Duyalt x tiplic laava:l Old style LauauJ.alow ,. ACCESSORY IIUILDINCw N/A Calve ta Cod Cottqa LiGr:ur car Colonial 1{.ow Town klouse 1lE: r.lChti'ct �Jariac]4/On4 cur/ two cat/ '�' /1CtiaCheG1 garagu,/ona Giar/ two ciarf ( CIRCL.L: ONL: PLEASE ) . ■ ■ ■ a IN IN IN ■ -a ■ ■ ■ r r x • • larivFatc: StaCia�jC building 1» .^.a01' xMA'I'1: D MhRKE"1' VAT. LlI: QV * Other coras`r' itUC'rxQN. 50 r 000 to 55 , 000 . 00 ' 1NF'ORKATTON ON DUIL DING SPRCIFICATTONS , ON REVERSE; SIDE: OF TSITS CHIRET, 'To Be COM.PLETV01 Farm BPA 30/88 V1 BUILDING PERMIT APPLICATION CONTINUED - BUILDING SPECIFICATIONS : NOTE : ALL ITEMS BELOW AJ:�E E?( T$TT..JIG Type of construction , wood frame , fire safe , etc . 8 " cARl7 uri f-h g-r- j'ck Tcp;r Po Will any second-hand or ungraded lumber be used? If so , for what ? No Foundation wall material N/A Thickness G " g_ejXif orced Concrete p . G . Depth of foundation below grade ( to bottom of footing ) 44R Will there be a cellar? NO . Heated or unheated? Floor sq_ footage sq ft Will there be a basement? No Will any portion be used as living space? ( if so , what portion? sq . ft . - - Type of use? Type of roof - sloped/flat/shed/other Exist . Material of roof Bui;l #�n P-� srab ,1 1 i C P4nmhraTTLe Vr Size , wood studs NIX " spacing "o . o t. length f . Joists ( floor beams ) lst . floor "X IV spacing IsoVc , span ft . Joists ( floor beams ) 2nd . floor "X IN spacing "o . c0 span ft . Overlays ( ceiling beams ) "X IN spacing "o . c . span ft . Roof rafters 2 "X 12 " spacing _16 p . c . span'_.�fto Roof trusses (pre-engineered) spacing "o . c . span ft . Exterior wall finish Brick Veneer t3f what material? Interior wall finish G Sum Board. If a garage is to be attached , describe materials to be used for FIRE SEPARATION : Is there to be an opening between garage and dwelling? If so will a Fire-rated door , enclosure , and self-closing device be provided? Will a flue-lined chimney be installed? Height above roof ft . Depth of chimney foundation below grade ft . Depth of fireplace hearth ft . ino water supply - Municipal or private well Mu n is ioa ], SEPTIC SYSTEM _ Distance from ANY private well ( including adjoining ,properties NT /A ft . (A separate application is necessary for any repair or new installation of septic system) DEC LA RATION To the best of my* knowledge and belief the statements contained in this application, together with the plans and specifications submitted, are a true and complete statement of all proposed work to be done on the described premises and that all provisions of the BUILDING CODE, THE kONING ORDINANCE, and all other laws pertaining to the propos =ner's mplied with, whether specified or not, and that such work is authori SignaturOw , are itect, contractor VAN SPECIAL CONDITIONS OF THE PERMIT : r' Dy.............__....--------- ------. = TOWN OF n, UEENSBURY jUARRE [J COUNTY , NEW YORK Application for : BUILDING ILDIN E N N C G PERMIT TIoMI LIANCCC�EWITlt TM! NEW YORK ION A permit must be olRtained before beginning work . ANSWER ALL of the following : 1 , Gross floor area 2280 S . F . L . P . Gas 2 . Ty �� � o f h .-: cat - - ----•-4-- 3 . Is the building mechanically cooled ? Yes - ( Part ) 4 , Percentage of area of windows and doors 2flW A . over 16 % Only 1 . ua vu-iuu of dross area of walls $ roof/ ceiling and floors ex ,posud to ambient conditions 1g Fog 2 , Floor over heated spaces YES Frost [ 'alI a . Ara foundation walls insulated ? NO' 8 . 34 10 If YL4S* what i. s the R value ? 3 . Slab on grade E NO a , If YES , what s the R valu ' of insular around ,perimeter of floor ? 4 . Is basement heated ? YES N [] Basement " IF R value of insulation _ 5 , Type of in :, ulati. on £1 . Under 1G1. only IIIIIIWWIFIII1 , it. value or root and floors exposed to ambient conditions .� , R Value Of exterior walls 3 . R value of glazed area n . R value of doors 5 . R value of floors over unheated apaces 5 . R value of slab edge insulation unheated slab 7 . R value of slab insulation - heated slab E3 . R value of heated basement/ cellar walls. ( above mgrade ) 9 . R value of heated basement/ceII43` walls ( below grade ) IQ * Type of insulation Co Controls 80 ,_Deg . F 1 . 01' 1, urmost4x maximum heat setting - D6 Duct Systems 10 , r x duct system installed in unheated spaces ? YES a , If yESO R value of duct installation bo it value of duct in other areas ' E , Pi inR Insulation let 1'jomest. ic 10 size of hoc water or coollng , carrying agent 2 , R value of pipe insulation Z/2R` T- nsulatzon PP F . Service Water Heating 75 Min . 1 . 1erfnr ►n :siic � � rciciency_ — F . 2 . '1' Qwpcuracuro control u4: ccinci maxi "kum Dec{ . - - — C . rro7C Swimmin�f Paol Dn1Y , ] Muxi �uuul heating /ram Telephone Nov 792 - 5382 ( Npp c s aturc: ) NOTE . THIS IS AN EXISTING BUILDING JC LGLi =4 al1Y GJa r ^lv4a kov. j zGo- ff / :J APPLICATION FOR ELECTRICAL INSPECTION PLEASE BEAR DOWN YOU ARE MAKING (4) COPIES MIDDLE DEPARTMENT INSPECTION AGENCY, INC. -. National Headquarters := 900 Haddon Ave-, Collingswood, N.J- 0810$ • Es • Date : 1/12 / 89 City, Town or Township Queensbury County Warren State NY Lo cation/Address Quaker Roar?? Formerly Dairy Queen ( If Located in Rural Area - Please Attach Directions) Poie # Owner Whole Donut Franchise , Inc . Permit # 9 Occupied As WrLolB nut Building : New D0 Donut OWEN Occupant Work Area in Buildin Floor 0, etc. ) . 2280 S . F . A . far: Wirin El Service = or: Ready for Inspection : Will call Fee Remitted - $ Cash 0 Check 0 M.O. E�l Make Pa able To : M.D. I.A. Number of fiauatr Wiring Outlets Elect. Heat Soo 754 1000 1250 1500 1750 2040 2250 2500 2750 ]000 Switches 13 _ Lighting Amp. Service Surface Unit Dishwasher Range Receptacles 25 Water Heater Air Conditioner Dryer Pump Number of Fixtures Oven Garbage Disposal Wiring and Controls far Burner 30 Amp. Receptacles Fractional H.P. Vent Fans Other Equipment: MOTO H.P, /2 / 1/10 1/8 1/S 1/+i 1/3 1/2 3/4 1 1112 2 3 5 7112 111 15 20 25 30 40 5a 75 100 Mark Nu ter of Each Si e Applicant's Signature License #�' � Permit # T/A Utility : NAME ��OFFIC�E Loch ory Applicant's Address: 4E4 � t3)ZfT7�''`� )''ram (City) l`t�/4J��'/ GDyx7 ,. (State) C= di p (Zip) e4�> � �' Service Request # Phone # p- ` -3 47 Electrician : • • DATE RECEIVED: DATE INSPECTED: Correct Location : Same as Above L�j or: Red Notice Label Rough Wiring Outlets Surface Unit Chen Switches Range Garbage Disposal Receptacles Water Heater Dishwasher Fixtures Air Conditioner Dryer Amp. Service Equipment Burner, Wiring & Controls for Amp. Receptacle Amp. Service Conductors Pump Vent Fans MOTORS U. 1/20 1/12 1/10 1/5 1/6 1/4 113 1/2 3/4 1 1�/s 2 3 5 74e777 25 3o AO 50 75 1 "0" Mark Number of Each Size ect. Meat 160,11 DO ISO 1040 1250 1504 1750 2000 2250 2500 2750 3000 0 Patrick J DasMalr I' "LsGn P a 2# 312839 < x '« El, TBICAL INSPECTOR, CERTIFICATIONS USE FOR INITIAL VISIT ONLY NOTIFIED DATE CORRECT FEE PAID RW Progress: Inc. LKD p Contractor CFT Violation : Work Comp. 0 Inc. CASH [] L/A Owner Fee CHK = L/A Due Mo # Q IPA Municipal MO # iNV # Date: Other Side 0 Utility Applicant Owner Cut in Card F'I Temp # Date Final 0 _ _ ____. . . Date INSPECTORS SiGNATUnE .r-s�vrrw�.cre�wa�rsar•+wrige/a�1farb+9.�sws +SA.'�Yi.Y�r�.' MIDDLE [DEPART AGENCYf INC. 61VIPJSP .__, . oast July 26 , Z9t39 �Pxttf[ E� that ,1,�'� f '�` ` "."_._---________�-�.� ' +� etjuipment listed has been exa i (ie0 an approved as being in accord with the National Elect plicable governmental, utility and goncy S. Sdhole Donut atiG i Owner.- T7�rirc�i.t Occupant: Same LCLg p Location: Quaker Road E'8i1& 11 (t a «jNdafe f "blec ric uipmont and mwallalwn inspected INS date 11 additional "w4tthenf sh be inleoduced Of aiterafions made td sals/Inq system thi C4111INda is be null and void, and app4cahon for Equipment: 120 Outlets 4 ecPptacles • �6,Q•y t �g �inspaCUOnbhoultP" submnt�7el0 tly10M06Agency. 400 Amp S e ry Wa' r ll e a te- " W.,L."F f 6 fu ,pddar of this certificate afwuId m same to his pfopen V insurance carrier yy y (egd Mt of Company)as evident[ erl lficaGon of a lac tr if:al act ulpmen l approved as specifletl , f r Boppitts Bldr Applicant. 36 Boulevard 1$ $ 3_` -._ Queertsl3ury , IVY ] 28Q + _ _ _ _- - o . 15 - 024671 It AM sw, sloth Wt- f.ss _ TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT G BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12809- TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED, NAME LOCATION / DATE �� �e7C — PERMIT # ' APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATIO NI DAMP-.PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ,ELECTRICAL. ROUGH-,IN INSULATION: FOUNDATION FLOORS EXW �LING INSPECTION: r' CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ TEPS STAIRS-CLEARANCE & RAILS� PLUMBING FIXTUR SIRELIEF LVE INTERIOR TRIM/ VACY DOOR FINISHED FLOOR GARAGE FIREPR FING DOOR CLOSER [S SMOKE DETE& S_ t FINAL ELECTRIC L INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: OA INSPECTOR TOWN OF QUEENSBURY ,BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280k TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCATION DATE PERMIT # ,APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP--PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUGH IN INSULATION FOUNDATION FLOORS WALLS AILING L,ofXNAL INSPECTION: ,y CHIMNEY HEIGHT ROOFING SIDING EXTERNAL POR ES/STEPS STAIRS-CLEA NCE & RAILS PLUMBING FI RES/RELIEF VALVE INTERIOR TM/PRIVACY DOORS, FINISHED FLPORS - GARAGE FIR PROOFING DOOR CLOSE(S)_ SMOKE DETECTORS FINAL ELECTCAL INSPECTION FINAL APPRO AL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FR M THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED{ REMARKS: 40 ,I , G9 l c" e I f colt4f! INSPECTOR Date _ • f C AC`Cr _ c"stitut s Cer+ijiCat; that the abo•,e insta!'ation, but nit the equip_ mer , itse'f a , has beer. 'dis�,la;iy ir.sDeCted , t s date pjrsuant tc t^v appf; - ar'4 rr, iec if r,';:�a tC t�'c t �•J-� `. Q. .. Te'S:t Sipr;5 tLte ac•'-''CBIiDr ;, - y' - ;;C- TOWN OF QUEENISBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK I280k TELEPHONE (518) 792-5832 BUILDING INSPECTOR' S REPORT REQUEST FOR I PECTION REC VED CG — / r NAME LOCATION DATE ! - Jae' I PERMIT ,APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATION/DAMP—PROOFING BACKFILL APPROVAL ROUGH PLUMBING FRAMING ELECTRICAL ROUCV# XN G.w'7NSULATION: `. FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: " CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/ TEPS STAIRS—CLEARANCE & RAI PLUMBING FIXTUR /RELIEF ALVE _ INTERIOR TRIM/ VACY DOC) FINISHED FL000R - GARAGE FIREPR FTNG DOOR CLOSER ( SMOKE DETEC RS FINAL ELECTRI L INSPECTION FINAL APPROVA OF CONSTRUCTION _ c A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: q INSPECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QuVENSBURY, NEW YORK 12804% TELEPHONE (518 ) 792--5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSP CTI RECEI D _ Zc NAME e LOCATION i lov y y DATE PERMIT # !/ } APPROVED YES NO FOOTINGIPIERS MONOLITHIC POU FORMS FOUNDATION/DAM PROOFING BACKF LL APPROV H PLUMBING FRAMING a ELECTRICAL ROUGH— INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION. CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHESYSTEPS STA.rRS—CLEARANC,t & RAILS PLUMBING FTX'TU ES/RELIEF VALVE INTERIOR TRIMIPRIVACY DOORS FINISHED FLOC�hS GARAGE FIREP,*OOFI NG DOOR CLOSER OS) SMOKE DETECTORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT .BEFORE THESE PREMISES' ARE OCCUPIED! REMARKS: I ECTOR TOWN OF QUEENSBURY BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 12809- TELEPHONE (528) 792- 5832 BUILDING INSPECTOR' S REPORT REQUEST FOR NSPECTION RECEIVED r NAME r �/,. I�„/) 0 � LOCATION _ �II PERMIT DATE ff ---- APPROVED YES I NO FOOTINGfPIERS MONOLITHIC POUR FORMS FOUNDATIONf DAMP°,-PROOFING BACKFILL APPROVA ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: f CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHE$fSTEPS STAIRS-CLEARANQ+ & RAILS PLUMBING FIXTt2ES/RELIEF VALVE INTERIOR TRI PRIVACY DOORS FINISHED F RS GARAGE FIRE ROOFING DOOR CLOSE (S) SMOKE DETE TORS FINAL ELECT ICAL -INSPECTION FINAL APPRO AL OF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIEDI REMARKS: INSPECTOR TOWN OF QUEENSBUR'Y BUILDING AND CODES DEPARTMENT BAY & HAVILAND ROADS QUEENSBURY, NEW YORK 1280!& TELEPHONE (518 ) 792- 5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED ,{ NAME ,r : / �;/ S r2 C,E f LOCATION _ DATE � . �j PERMIT # © / APPROVED YES NO FOOTING/PIERS MONOLITHIC POUR FORMS FOUNDATIONIDAMP-PROOFING BAC ILL APPROVAL� �t1GH PLUMBING id H �° y FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: e CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/S,flEPS STAIRS-CLEARANCE 4& RAILS PLUMBING FIXTURES/RELIEF VALVE INTERIOR TRIM/PRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER (S) SMOKE DETECTOR,$' FINAL ELECTRICAL' INSPECTION FINAL APPROVAL dF CONSTRUCTION A SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIEDi REMARKS: NSPEC 16 TOWN OF QUEENSBURY � BUILDING AND CODES DEPARTMENT HAY & HAVILAND ROADS QUEENSBURY, NEW YORK I2809- TELEPHONE (518 ) 792-5832 BUILDING INSPECTOR ' S REPORT REQUEST FOR INSPECTION RECEIVED NAME LOCAT ION , ,a DATE PERMITf I APPROVED YES NO FOO�TXNGIPXERS NOLITHIC POUR FORMS FOUNDATIONIDAMP—PROOFING BACKFYLL APF VAL ROUGH PLUMBIN FRAMING ELECTRICAL ROUG --IN INSULATION: ` FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION : CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHESISTEPSi _ STAIRS—CLEARANCE & RAt LS PLUMBING FIXTURESIRE�IEF LVE INTERIOR TRIMIPRIVAFY DOOR FINISHED FLOORS GARAGE FIREPROOFI G DOOR CLOSER (S) s ` SMOKE DETECTORS C FINAL ELECTRICAL NSPECTION FINAL APPROVAL O CONSTRUCTION A SIGNED CE!:2 I ICATE OF OCCUPANCY MUST BE OBTAINED FROM 4HE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIEDf REMARKS: i i INSPECTOR I.r TOWN OF QL3EEhISBURY � BUILDING AND CODES DEPARTMENT BAY & HA VILAND ROADS QUEENSBURY, NEW YORK 1280k TELEPHONE (518 ) 792- 5832 BUILDING INSPECTOR' S REPORT REQUEST FOR INSPECTION RECEIVED �} ,G NAME LOCATION DATE ^.. ,.. -PERMIT 3# �#7 APPROVED YES NO OOTING PIERS MONOLITHIC POUR FORMS _.... FOUNDATION; BACKFILL APPROVAL _ ROUGH PLUMBING FRAMING ELECTRICAL ROUGH-IN INSULATION: FOUNDATION FLOORS WALLS CEILING FINAL INSPECTION: CHIMNEY HEIGHT ROOFING SIDING EXTERNAL PORCHES/STEPS STAIRS-CLEARANCEf & RAILS PLUMBING FIXTURS/RELSEF VALVE INTERIOR TRIM/)PRIVACY DOORS FINISHED FLOORS GARAGE FIREPROOFING DOOR CLOSER () SMOKE DETECLrORS FINAL ELECTRICAL INSPECTION FINAL APPROVAL OF CONSTRUCTION A .SIGNED CERTIFICATE OF OCCUPANCY MUST BE OBTAINED FROM THE BUILDING DEPARTMENT BEFORE THESE PREMISES ARE OCCUPIED! REMARKS: r Ae INSPECTOR r+- `MIDDLE DEPARTMENT,IXIISPECTION AGENCY, INC.'" National Headquarters 900 Haddon Ave., Collingswood, N.J. 08108 7Owner Date : r.TownsMFy County Stateress Onake`r �a w2 Formrerlg Da13.1'y. {+e� 64m (if Located in Rural Area - Please Attach Directions) Pole #hole 131D3 ult V*iranchteev I>< c + Permit # �-Banding: NewEOld228f! +"Work Area in BuiWin Floor #, etc. +nn Service � or; Read for inspection : ` Fee Remitted - $r Cash d Check © M.Q. C] Make Payable To: M.D. I.A. OiM 1230 1500 1750 2044 225° 2544 2764 Number of RouS1 Wirino Outlets Elect. Heat S40 750 I 3400 Switches Lighting -- Amp. Service Surface Unit Dishwasher Range ZilWater Heater Air Conditioner Dryer Pump f' Receptacle Number of Fixtures Oven Garbage Disposal Wiring and Controls for Burner 30 Amp. Receptacles Fractional H.P. Vent Fans Other Equipment: MOTOR P, 12 - 1 1/10 1/e 1/6 1/4 1/3 1/2 3/4 1 1>/x 2 3 5 716 10 15 20 25 30 40 50 75 100 Mark Nu bir of Each SI f Applicant's Signature License # Permit # T/A rej ,l r_ I� 1 'I /f11 Utility : NAM (OFFICE L APPliranie.'�o Atirlrr�sc� .+"'s .�E-R (City) +�{ + + � � _._ ('State) C: C-M./Vt . Zip) ��"� 04; Service Request # Phone #_ ��- -*�``T ` 73 45r''^ ce Electrician : DATE RECEIVED: DATE INSPECTED: a Correct Location : Same as Above or; Red Notice Label [] Rough Wiring Outlets Surface Unit Oven Switches Range Garbage Disposal Receptacles Water Heater Dishwasher Fixtures Air Conditioner Dryer T Amp. Service Equipment Burner, Wiring & Controls for Amp, Receptacle Amp. Service Conductors Pump Vent Fans MOTORS H.P. 1/20 1112 1f10 1/a 116 lf4 ]13 1122 3 1, 1 2 3 5 7% 10 15 20 25 30 40 50 7'.S` 100 Mark Number of Each Size 11 Elect. Has SOO 750 1000 1 1250 1500 1754 2004 "s4 2 454 27s4 io44 I RW Progress: Inc. LKD Contractor CFT Violation : Work Comp. 0 Ina 0 CASH L/A Owner 7 Mo Fee CHK # F1 QA Due Iy10 # 0 IPA Municipal # INV Date: Other Side Utility Applicant Owner Cut in Cara Temp # Date Q Final # Date INSPECTORS SIGNATURE APPLICATIOP4 FORM NO. 250 EL 11/46 -- ---.� APPLICANT'S COPY MIDDLE DEPARTMENT INSPECTION AGENCY, INC. NATIONAL HEADQUARTERS: 900 Ftaddon Ave., Collingswood, N .J. 08108- (609) 858-4400 DELAWARE NEW JERSEY 1815 Newport Gap Pike 1030 Kings Highway North 1525 Cedar Cliff Dr. Marshallton, Del. .19808 Suite 310 Camp Hill, Pa. 17011 (302) 999-0243 Cherry Hill , N .J. 08034 (717) 761 -5340 (609) 667-9200 203 N. E . Front Street 1542 Bristol Pike Suite 105 Rear Entrance 350 Grove Street U.S. Route 13 P.Q. Box 306 Grove X X I I Corner Bensalem, Pa. 19020 Milford, Del. 19963 Bridgewater, N.J. 08807 (215) 244-1919 (302) 422-5729 ( 201 ) 526-0880 (302) 856-2218 Route 19, North 26 S. State Street P.O. Box 136 Hackensack, N.J. 07602 Wexford, Pa. 15090 MARYLAND ( 201 ) 487-5373 (412) 931 -3028 (412) 935-1558 Milford Professional Bldg. Route 9 3610 Milford Mill Road Marmora, N.J. 08223 Baltimore, Md. 21207 (609) 390-1940 VIRGINIA (301 ) 922- 1122 NEW YORK 3076 Shawnee Drive Burch Oil Co. Bldg, P.O . Box 1626 EIS Route 5 706 Erie Boulevard West Winchester, Va. 22601 Charlotte Hall, Md. 20622 P.O. Box 285 (703) 667-8484 (301 ) 645-2219 Rome, N .Y . 13440 (301 ) 884-4547 (315) 736-0477 (315) 337-3480 Washington Co. Off ice Bldg, 460 State Street 33 W. Washington Ave. Suite 308 Hagerstown, Md. 21740 'Rochester, MY. ,14608 (301 ) 791 -3190 (716) 454-5191 Hitch Bldg. Room 203 243 Margaret Street. 636 S. Salisbury Blvd. Plattsburgh, N . Y. 12901 Salisbury, Md. 21801 (518) 563-2835 (301 ) 749-0641 Room 301 Main Street PENNSYLVANIA Court House 121 W. Tenth Street Elkton, Md. 21921 Erie, Pa. 16501 (301 ) 398-5200 (814) 452-4604 318 Commerce Drive 18 N . Wyoming Ave. Easton, Md , 21601 Room 204 (301 ) 822-8300 Kingston, Pa. 18704 (717) 288-4906 NOTICE TO APPLICANTS_ Final inspection and approval may be required by law before electrical current may be energized for use of occupants. The Agency undertakes to provide inspections until final certification is granted if such requests are made within 120 days -from date of the last inspection. Upon expiration of 120 days from the date of the most recent inspection, all duties and obligations owed by the Agency shall be deemed completed, and all fees paid by applicant shall be deemed consideration for services performed. No further inspections shall be undertaken by the Agency without filing of a new application, and the payment of relevant inspection fees. No final certification shall be implied or inferred without issuance of a duly executed certificate. The Agency in accepting application for inspection cannot assume responsibility for unavoidable delays in inspection. "100 YEARS" PROTECTING THE CONTRACTOR AND THE CONSUMER. (law TOWN OF Q +UEENSB UR Y Bay at Haviiand Road, Queensbury, NY 1 2804-9 725-5 1 8-792-5832 February 27 , 1989 TO : The Building Department FROM : Fire Marshal Bodenweiser RE : The Whole Donut The following items would be required : 1 . Due to traffic patterns proximity to the propane tank , it will be required that a speed bump be affixed in the outer driveway as shown . 2 . Require specifications on fire suppression system in hood . 3 . Hand fire extinguishers locations to be determined prior to issuance of C/O . 4 . Require two sets of emergency lighty in approximate area shown . BB/cg cc : The Whole Donut Franchise "HOME OF NATURAL. BEAUTY . _ _ A GOOD PLACE TO LIVE" SETTLED 1763